Provider Demographics
NPI:1144228271
Name:ROSI, DAVID A (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:ROSI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 MCLURE CT
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6174
Mailing Address - Country:US
Mailing Address - Phone:843-665-2900
Mailing Address - Fax:843-629-8122
Practice Address - Street 1:1521 MCLURE CT
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6174
Practice Address - Country:US
Practice Address - Phone:843-665-2900
Practice Address - Fax:843-629-8122
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC39814207Y00000X
IN02001925A207Y00000X
OH34.010285207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000093607OtherANTHEM
IN200170670Medicaid
ING26140Medicare UPIN
ING26140Medicare UPIN